Epidemiology and Health

Original Article

Pros and cons of the health transformation program in Iran: evidence from financial outcomes at the household level: Enayatollah Homaie Rad, Vahid Yazdi-Feyzabad, Shahrokh Yousefzadeh-Chabok, Abolhasan Afkar, Ahmad Naghibzadeh; Epidemiol Health. 2017;39:e2017029. Published online July 18, 2017; DOI: https://doi.org/10.4178/epih.e2017029

20,258 View
203 Download
28 Web of Science
19 Crossref

Abstract

OBJECTIVES
The health transformation program was a recent reform in the health system of Iran that was implemented in early 2014. Some of the program’s important goals were to improve the equity of payments and to reduce out-of-pocket (OOP) payments and catastrophic health expenditures (CHE). In this study, these goals were evaluated using a before-and-after analysis.

METHODS

Data on household income and expenditures in Guilan Province were gathered for the years 2013 and 2015. OOP payments for outpatient, inpatient, and drug services were calculated, and the results were compared using the propensity score matching technique after adjusting for confounding variables. Concentration indices and curves were added to quantify changes in inequity before and after the reform. The incidence of catastrophic expenditures was then calculated.

RESULTS

Overall and outpatient service OOP payments increased by approximately 10 dollars, while for other types of services, no significant changes were found. Inequity and utilization of services did not change after the reform. However, a significant reduction was observed in CHE incidence (5.75 to 3.82%).

CONCLUSIONS

The reform was successful in decreasing the incidence of CHE, but not in reducing the monetary amount of OOP payments or affecting the frequency of health service utilization.

Summary

Citations

Citations to this article as recorded by

Inequity in out-of-pocket expenditure and utilization of laboratory tests in Iran: lessons learned in human rights
Rauf Kord, Enayatollah Homaie Rad, Ali Davoudi Kiakalayeh
International Journal of Human Rights in Healthcare.2023; 16(4): 402. CrossRef
Measuring Catastrophic Costs in Families Facing Traumatic Brain Injury in Iran
Elham Gheysvandi, Seyedeh Zahra Mohammadi, Mahdiyeh Najafpour Amirkiyasar, Enayatollah Homaie Rad, Leila Kouchakinejad-Eramsadati, Zahra Mohtasham-Amiri
Korean Journal of Neurotrauma.2023; 19(1): 53. CrossRef
To what extent has the Iranian Health Transformation Plan addressed inequality in healthcare financing in Iran?
Maryam Moeeni, Shirin Nosratnejad, Manizhe Rostampour, Koen Ponnet
International Journal for Equity in Health.2023;[Epub] CrossRef
What Policy Approaches Were Effective in Reducing Catastrophic Health Expenditure? A Systematic Review of Studies from Multiple Countries
HyunWoo Jung, Kwang-Soo Lee
Applied Health Economics and Health Policy.2022; 20(4): 525. CrossRef
Putting the Neoliberal Transformation of Turkish Healthcare System and Its Problems into a Historical Perspective
Emrah Konuralp, Sermin Bicer
Review of Radical Political Economics.2021; 53(4): 654. CrossRef
Thematic analysis of the policies of Iran's health higher education
Mitra Sarshar, Shahram Yazdani, Mohammad Pooyan Jadidfard, Lida Shams
Journal of Education and Health Promotion.2021; 10(1): 217. CrossRef
Ranking of Iranian provinces based on healthcare infrastructures: before and after implementation of Health Transformation Plan
Payam Shojaei, Najmeh bordbar, Arash Ghanbarzadegan, Maryam Najibi, Peivand Bastani
Cost Effectiveness and Resource Allocation.2020;[Epub] CrossRef
Effect of two major health reforms on health care cost and utilization in Fars Province of Iran: family physician program and health transformation plan
Mohsen Bayati, Khosro Keshavarz, Farhad Lotfi, Abbas KebriaeeZadeh, Omid Barati, Shahram Zareian, Akbar Amiri, Sajad Delavari
BMC Health Services Research.2020;[Epub] CrossRef
Identifying National Health Priorities: Content Analysis of the Islamic Republic of Iran's General Health Policies (GHPs)
Haniye Sadat Sajadi, Fateme Gholamreza Kashi, Reza Majdzadeh
World Medical & Health Policy.2020; 12(2): 123. CrossRef
The challenges of providing primary health care to Afghan immigrants in Tehran: a key global human right issue
Afsaneh Takbiri, AmirHossein Takian, Abbas Rahimi Foroushani, Ebrahim Jaafaripooyan
International Journal of Human Rights in Healthcare.2020; 13(3): 259. CrossRef
Explaining Socioeconomic Inequality Differences in Catastrophic Health Expenditure Between Urban and Rural Areas of Iran After Health Transformation Plan Implementation

Ali Kazemi-Karyani, Abraha Woldemichael, Moslem Soofi, Behzad Karami Matin, Shahin Soltani, Jafar Yahyavi Dizaj
ClinicoEconomics and Outcomes Research.2020; Volume 12: 669. CrossRef
A critical analysis of Iran health system reform plan
Fatemeh Kalroozi, Nooredin Mohammadi, MansourehAshghali Farahani, BehzadHaghighi Aski, AliManafi Anari
Journal of Education and Health Promotion.2020; 9(1): 364. CrossRef
Catastrophic healthcare expenditures among Iranian households: a systematic review and meta-analysis
Satar Rezaei, Abraha Woldemichael, Mohammad Hajizadeh, Ali Kazemi Karyani
International Journal of Human Rights in Healthcare.2019; 12(2): 105. CrossRef
Health informal payments and their main determinants: The case of Iran
Mohammad Meskarpour Amiri, Ehsan Teymourzadeh, Ramin Ravangard, Mohammadkarim Bahadori
Proceedings of Singapore Healthcare.2019;[Epub] CrossRef
Catastrophic Health Expenditure in Households with Severe Mental Disorders Patients: Evidence After Iran's Health Transformation Plan
Eshagh Barfar, Abolghasem Pourreza, Vandad Sharifi, Seyed Mohammad Hadi Sobhanian, Ali Akbari Sari
Health Scope.2019;[Epub] CrossRef
Health Financing Consequences of Implementing Health Transformation Plan in Iran: Achievements and Challenges
Leila Doshmangir, Mohammad Bazyar, Behzad Najafi, Hassan Haghparast-Bidgoli
International Journal of Health Policy and Management.2019; 8(6): 384. CrossRef
Health Care Utilization Inequality in a Mixed Public-Private Health Care System: An Insight from the National Survey in Iran
Mohammadreza Zakeri, Kamran Bagheri Lankarani, Zahra Kavosi, Ramin Ravangard
Health Scope.2019;[Epub] CrossRef
Consumer Instigated Unnecessary Medicalization in Iran: A Qualitative Thematic Analysis of the Health Professionals’ Conjectures
Abdolreza Shaghaghi, Parinaz Doshmangir
Health Scope.2018;[Epub] CrossRef
Inpatient Out-of-Pocket in Iran After Health Transformation Plan
Sulmaz Ghahramani, Kamran Bagheri Lankarani
International Journal of Health Policy and Management.2018; 7(9): 877. CrossRef

First
Prev
Page of 1
Next
Last

Search